Technical Review of How to Determine the Exact Location of Needle Tip During Office-Based Injection Augmentation of the Vocal Folds Via Cricothyroid Approach

외래에서 시행하는 경윤상갑상막 접근 성대주입술 중 주입 위치를 정확하게 파악하는 방법에 관한 기술적 고찰

  • Park, Sung Joon (Department of Otorhinolaryngology & Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kwon, Tack-Kyun (Department of Otorhinolaryngology & Head and Neck Surgery, Seoul National University College of Medicine)
  • 박성준 (가톨릭대학교 의과대학 이비인후과학교실) ;
  • 권택균 (서울대학교 의과대학 이비인후과학교실)
  • Received : 2017.11.22
  • Accepted : 2018.11.18
  • Published : 2018.12.30


The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.



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